Indigenous Australians and Critical Health

Should students be aware of the history of Indigenous Australians and study the critical health consequences to enable an understanding of the current health status of Aboriginal & Torres Strait Islander people?

Culture is constantly changing, often through contact with other cultures. (Papalia, Olds & Feldman, 2004). Being aware of the history of Indigenous Australians to some small degree would be beneficial, however, going back in time to the 1700’s, 1800’s and even up to the very early 1900’s, is quite irrelevant to today’s current health status because, over the hundreds of years that have past by, technology has been introduced, as well as new and improved medicines and procedures. Australian nursing has to examine its past in relation to the treatment of Aboriginal Australians, rather than the history of these people. (Journal of Advanced Nursing, 2007).

Imagine if nursing students and health professionals were expected to have a full understanding of the history of every culture that encompassed our world. Aboriginal and Torres Strait Islanders experience lower incomes, higher rates of unemployment and poorer educational outcomes – all of which can impact upon a person’s health and wellbeing. (Australian Institute of Health and Welfare, 2006). I believe that we do not need to acknowledge the history of Indigenous Australians in great depth, but to move forward to the here and now to improve the problems just mentioned, and other activities that enhance well being, and that further research into Aboriginal & Torres Strait Islander people would be more relevant and beneficial to students and health professionals. (BMJ, The health status of Indigenous peoples and others, 2003).

As nursing students and health professionals, we can still achieve understanding of the critical health consequences and deal with the current health issues of Aboriginal & Torres Strait Islander people by skill sharing in the workforce or educational facility, and learning from other Aboriginal health workers and nurses, without having to dive deep into the realms of their full blown history. (Journal of Advanced Nursing, 2007). While some of that history may be in the past, other history may be relatively recent and very much alive for the people concerned. (Talbot & Verrinder, 2005).

Books and articles are a limited way of finding out about other cultures, and often represent a very limited view of the cultures they discuss. Perhaps the most useful skill for a health worker or a student nurse working with people from other cultural backgrounds such as, Aboriginal & Torres Strait Islander people is sensitivity, including, but certainly not limited to, intercultural sensitivity, rather than studying their history and the critical health consequences that were prevalent back hundreds of years ago. (Talbot & Verrinder, 2005).

By being culturally sensitive, this will enable us to still understand their current health status without having to study their history. Health to Aboriginal people is more a matter of determining all aspects of their lives, including control over their physical environment, dignity, community, self-esteem and justice. When one works in a rural or Indigenous context, it reinforces the importance of working from the Indigenous or rural person’s world view, and their understandings of health in today’s day and age and not back in the past. (Smith, 2004).

Upon considering the implications for nursing practice, I have chosen to give an example to help explain how I feel as a student nurse, about learning the history of Indigenous Australians.

Example: An Aboriginal or Torres Strait Islander presents to an A&E department of a health facility. He/she displays flu like symptoms and complains of abdominal pains. As a nurse, studying their history back hundreds of years ago is not going to help me diagnose the underlying cause of their medical problem. I do not need to know who their ancestors were 100, 200 or 300 years ago, how they hunted for food, what they ate, or what tribal medicines they used back then. The only type of history that is relevant to this current day and age for this patient is their immediate family medical history, and the nursing history I will acquire from them as a health professional.

Leininger (1997b) believes that nurses need to know about individuals, families, groups and institutions in diverse health systems if they are to deliver culturally appropriate care. (Greenwood, 2005). Having said this, there really is no need to learn about the history of the Indigenous Australians to understand their current health status, as the Aboriginal Health Services in Australia was formulated in the late sixties to improve the delivery of culturally appropriate health care to Aboriginal people. The fundamental principles behind community-controlled Aboriginal Health Services are (1) the key health provider is the Aboriginal health worker, complemented by nurses and doctors, and (2) the principal role of the Aboriginal Health Services is primary health care, although the services also play an advocacy role in Aboriginal issues. (Greenwood, 2005).

Reflecting on the research and numerous articles that I have read on the topic up for

debate, I would be lying if I said that my opinion had not been swayed at all. Upon commencing this debate, my opinions were very much leaning towards the positive aspects of this particular topic. I felt that studying the history of Australian Aboriginals needed to be a prerequisite for health professionals and nursing students, to enable us to understand why they have the physical, mental and emotional problems that exist today. I have since learnt and now strongly believe that this is not the case, and that we need to deal with the current health problems and their consequences that are presented to us on a daily basis within the Indigenous community, and not the issues that existed hundreds of years ago.

It is important that, not just as health professionals, but as human beings, we exercise Cultural awareness, in which we understand that there is difference, Cultural sensitivity, where we legitimise this difference, and Cultural safety, where we provide safe service to all cultures. (Smith, 2005). Ron Hampton at The University of Southern Queensland considers all health practitioners need awareness of Indigenous culture. (Australian Nursing Journal, 2007). The best statement that I personally believe sums up this topic appropriately is that we as health professionals need to treat the patient not treat their history.